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Socio-demographic factors Influencing National Health Insurance Registration for Free Maternal Healthcare among Pregnant Women in a Rural District in Ghana
Article Number: SIS523498AI180724
18th July, 2024
Author(s):
Richmond Bediako Nsiah, Margaretta Gloria Chandi, Solomon Anum-Doku, Saviour Katamani, Dominic Nyarko
Abstract:
Access to maternal healthcare services is
crucial in reducing maternal mortality rates, particularly in rural areas of
developing countries like Ghana. The National Health Insurance Scheme (NHIS) in
Ghana offers free maternal healthcare services to registered pregnant women,
yet uptake remains low in rural districts. Understanding the socio-demographic
factors influencing NHIS registration among pregnant women is essential for
targeted interventions to improve maternal health outcomes. A cross-sectional
study was conducted in Offinso North District of Ghana, involving 397 pregnant
women accessing antenatal care services. A structured questionnaire was
administered to collect socio-demographic data and information on NHIS
registration status. Data were analyzed using descriptive statistics and
logistic regression to determine factors associated with NHIS registration. The
prevalence of National Health Insurance Scheme (NHIS) registration among the
interviewed pregnant women was exceptionally high, reaching 98%, with
approximately 87% maintaining active NHIS membership. The NHIS registration
exhibited statistically significant associations with marital status (χ2=7.20; p=0.01). Moreover, the maintenance
of active NHIS membership was significantly associated with various demographic
factors, including age (χ2=5.00;
p=0.03), educational level (χ2=8.77;
p=0.00), marital status (χ2=5.38;
p=0.02), and gestational age of pregnancy (χ2=5.84; p=0.02). Married respondents demonstrated a twofold
likelihood of NHIS registration compared to their unmarried counterparts
(AOR=2.05, [95%CI (1.53-39.69)], p=0.013). Conversely, respondents aged over 19
years were 0.5 times less likely to maintain active NHIS membership compared to
teenage respondents (AOR=0.95, [95%CI (1.00-6.667)], p=0.050). Notably,
respondents in their 35th week of pregnancy exhibited twice the likelihood of
maintaining active NHIS membership compared to those with pregnancies below 35
weeks (AOR=2.08, [95%CI (1.03-61.80)], p=0.047). Socio-demographic factors such
as age, education level, marital status, and gestational age of pregnancy
significantly influenced active membership of National Health Insurance for
free maternal healthcare among pregnant women in rural Ghana. These findings
underscore the importance of targeted interventions to address
socio-demographic disparities and enhance NHIS registration among pregnant
women, ultimately improving maternal and child health outcomes in rural Ghana.